MEDICARE: SHARI ZALOSKI RPH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	31870	TX

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	31870	OTHER	TX	PHARMACIST LICENSE

General Provider Information

NPI Number	:	1881184703
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHARI ZALOSKI RPH

Provider Business Mailing Address
First Line	:	697 FERGUSON RD
Second Line	:
City	:	HOLLIDAY
State	:	TX
Zip	:	76366-3814
Country	:	US
Telephone Number	:	940-867-8530
Fax Number	:

Provider Business Practice Location Address
First Line	:	4516 JACKSBORO HWY
Second Line	:
City	:	WICHITA FALLS
State	:	TX
Zip	:	76302-2920
Country	:	US
Telephone Number	:	940-767-3368
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/16/2018
Last Update Date	:	05/16/2018

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